Background <p>Hypertension continues to be a major cause of illness and death worldwide, with its prevalence rising quickly in low- and middle-income countries. In Ghana, market women are a crucial socio-economic group that are disproportionately exposed to risk factors for hypertension, yet few comprehensive studies have focused on this population.</p> Objective <p>This study aimed to explore the determinants of hypertension among market women at the Sunyani Wednesday Market, focusing on qualitative insights into their experiences, health behaviors, and challenges in accessing care.</p> Methods <p>A qualitative descriptive study was carried out using purposive sampling to select 30 market women aged 25–60 years. Data were gathered through semi-structured interviews and were analyzed thematically.</p> Results <p>Five major themes emerged: Market women showed strong awareness of hypertension, often identifying it as a community health concern and sharing personal or observed experiences; their diets frequently included high-salt and fried foods, and they faced occupational stress from competition, financial insecurity, and long hours. Physical activity was limited, especially formal exercise, and access to healthcare was challenged by cost, distance, and waiting times. Many preferred traditional herbal remedies due to cultural and economic factors. These combined issues increase the risk of hypertension and make effective management difficult.</p> Conclusion <p>Hypertension among Sunyani market women is driven by poor diet, work stress, low physical activity, and limited healthcare access, requiring culturally tailored interventions in education, workplace support, healthcare, and community engagement to improve heart health and equity.</p>